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飞机噪声暴露对全身和肾脏血液动力学的影响。

The influence of aircraft noise exposure on the systemic and renal haemodynamics.

机构信息

Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany.

Department of Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany.

出版信息

Eur J Prev Cardiol. 2022 Feb 19;29(1):116-124. doi: 10.1093/eurjpc/zwaa036.

Abstract

AIMS

Epidemiological studies found a link between aircraft noise exposure and increased incidence of arterial hypertension and cardiovascular disease, but the underlying pathophysiological mechanisms are not fully understood. Clinical studies have shown that mental stress affects the systemic and renal haemodynamic, but no such study was performed with noise exposure as stress factor. We analysed systemic and renal effects of 25 min standardized aircraft noise in a sham controlled clinical study including 80 healthy men and 34 male patients with hypertension.

METHODS AND RESULTS

Systemic haemodynamic parameters were measured using electrocardiography and impedance cardiography. The renal haemodynamic was assessed using steady state input clearance with infusion of para-aminohippuric acid and inulin for glomerular filtration rate and renal plasma flow, respectively. In the systemic circulation of hypertensive patients, there was an increase in total peripheral resistance (TPR) (1420 ± 387 vs. 1640 ± 516 dyn·s·cm-5, P = 0.001) and a decrease in cardiac index (CI) (2.9 ± 0.8 vs. 2.6 ± 0.8 L/(min·m2, P < 0.001) 25 min after the start of noise exposure, which was not present during sham procedure (P = 0.10, P = 0.86). In healthy individuals a procedure induced increase in TPR and decrease in CI was present after noise (TPR: 995 ± 239 vs. 1106 ± 308 dyn·s·cm-5, P = 0.001, CI: 3.6 ± 0.7 vs. 3.3 ± 0.9 L/(min·m2, P < 0.001) and sham application (TPR: P = 0.002, CI: P < 0.001). However, in healthy individuals changes in TPR (P = 0.450) and CI (P = 0.605) from baseline until 25 min after the start of the intervention did not differ between noise and sham exposure. In the renal circulation of hypertensive patients and healthy individuals the response did not differ between noise and sham procedure.

CONCLUSIONS

In hypertensive but not healthy men we observed a systemic vasoconstrictive response after aircraft noise exposure accompanied by a decrease in CI. No significant changes were observed in the renal circulation. Our results suggest that male hypertensive patients are more susceptible for noise-induced changes of vascular resistance in the systemic circulation.

摘要

目的

流行病学研究发现,飞机噪声暴露与动脉高血压和心血管疾病发病率增加之间存在关联,但潜在的病理生理机制尚不完全清楚。临床研究表明,精神应激会影响全身和肾脏血流动力学,但尚未有研究以噪声暴露作为应激因素进行此类研究。我们在一项包括 80 名健康男性和 34 名高血压男性患者的假对照临床研究中,分析了 25 分钟标准化飞机噪声对全身和肾脏的影响。

方法和结果

使用心电图和阻抗心动图测量全身血流动力学参数。使用持续输入清除率分别输注对氨基马尿酸和菊粉评估肾脏血流动力学,以评估肾小球滤过率和肾血浆流量。在高血压患者的全身循环中,总外周阻力(TPR)增加(1420±387 对 1640±516 dyn·s·cm-5,P=0.001),心输出量(CI)降低(2.9±0.8 对 2.6±0.8 L/(min·m2,P<0.001)),噪声开始后 25 分钟,而在假手术过程中未出现这种情况(P=0.10,P=0.86)。在健康个体中,在噪声(TPR:995±239 对 1106±308 dyn·s·cm-5,P=0.001,CI:3.6±0.7 对 3.3±0.9 L/(min·m2,P<0.001)和假手术(TPR:P=0.002,CI:P<0.001)应用后,存在程序诱导的 TPR 增加和 CI 降低。然而,在健康个体中,从基线到干预开始后 25 分钟,TPR(P=0.450)和 CI(P=0.605)的变化在噪声和假暴露之间没有差异。在高血压患者和健康个体的肾脏循环中,噪声和假手术程序之间的反应没有差异。

结论

在高血压男性中,但不是健康男性中,我们观察到飞机噪声暴露后全身血管收缩反应伴有 CI 降低。在肾脏循环中未观察到明显变化。我们的结果表明,男性高血压患者对全身循环中血管阻力的噪声诱导变化更敏感。

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